title: Pathways to quality inpatient management of hyperglycemia and diabetes: a call to action.
abstract: Currently patients with diabetes comprise up to 25-30% of the census of adult wards and critical care units in our hospitals. Although evidence suggests that avoidance of hyperglycemia (>180 mg/dL) and hypoglycemia (<70 mg/dL) is beneficial for positive outcomes in the hospitalized patient, much of this evidence remains controversial and at times somewhat contradictory. We have recently formed a consortium for Planning Research in Inpatient Diabetes (PRIDE) with the goal of promoting clinical research in the area of management of hyperglycemia and diabetes in the hospital. In this article, we outline eight aspects of inpatient glucose management in which randomized clinical trials are needed. We refer to four as system-based issues and four as patient-based issues. We urge further progress in the science of inpatient diabetes management. We hope this call to action is supported by the American Diabetes Association, The Endocrine Society, the American Association of Clinical Endocrinologists, the American Heart Association, the European Association for the Study of Diabetes, the International Diabetes Federation, and the Society of Hospital Medicine. Appropriate federal research funding in this area will help ensure high-quality investigations, the results of which will advance the field. Future clinical trials will allow practitioners to develop optimal approaches for the management of hyperglycemia in the hospitalized patient and lessen the economic and human burden of poor glycemic control and its associated complications and comorbidities in the inpatient setting.
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, University of Colorado School of Medicine, Aurora, Colorado, USA. boris.draznin@ucdenver.edu
authors.forename: Boris
authors.initials: B
authors.lastname: Draznin
authors.forename: Janice
authors.initials: J
authors.lastname: Gilden
authors.forename: Sherita H
authors.initials: SH
authors.lastname: Golden
authors.forename: Silvio E
authors.initials: SE
authors.lastname: Inzucchi
authors.forename: David
authors.initials: D
authors.lastname: Baldwin
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Bode
authors.forename: Jeffrey B
authors.initials: JB
authors.lastname: Boord
authors.forename: Susan S
authors.initials: SS
authors.lastname: Braithwaite
authors.forename: Enrico
authors.initials: E
authors.lastname: Cagliero
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Dungan
authors.forename: Mercedes
authors.initials: M
authors.lastname: Falciglia
authors.forename: M Kathleen
authors.initials: MK
authors.lastname: Figaro
authors.forename: Irl B
authors.initials: IB
authors.lastname: Hirsch
authors.forename: David
authors.initials: D
authors.lastname: Klonoff
authors.forename: Mary T
authors.initials: MT
authors.lastname: Korytkowski
authors.forename: Mikhail
authors.initials: M
authors.lastname: Kosiborod
authors.forename: Lillian F
authors.initials: LF
authors.lastname: Lien
authors.forename: Michelle F
authors.initials: MF
authors.lastname: Magee
authors.forename: Umesh
authors.initials: U
authors.lastname: Masharani
authors.forename: Gregory
authors.initials: G
authors.lastname: Maynard
authors.forename: Marie E
authors.initials: ME
authors.lastname: McDonnell
authors.forename: Eti S
authors.initials: ES
authors.lastname: Moghissi
authors.forename: Neda
authors.initials: N
authors.lastname: Rasouli
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rubin
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Rushakoff
authors.forename: Archana R
authors.initials: AR
authors.lastname: Sadhu
authors.forename: Stanley
authors.initials: S
authors.lastname: Schwartz
authors.forename: Jane Jeffrie
authors.initials: JJ
authors.lastname: Seley
authors.forename: Guillermo E
authors.initials: GE
authors.lastname: Umpierrez
authors.forename: Robert A
authors.initials: RA
authors.lastname: Vigersky
authors.forename: Cecilia C
authors.initials: CC
authors.lastname: Low
authors.forename: Deborah J
authors.initials: DJ
authors.lastname: Wexler
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007297:Inpatients
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents